If you suffer from anxiety and have gastrointestinal (GI) issues like acid reflux, irritable bowel syndrome (IBS), or inflammatory bowel diseases, you’re not alone. There is a very real, biological connection between your gut health and mental health.
As Dr. Tracey Marks, a psychiatrist who specializes in mental health education, explains in her video, numerous studies have found evidence of a bi-directional relationship between GI disorders and anxiety/depression. But what does that actually mean?
It means that not only can anxiety and stress exacerbate GI symptoms, but having an underlying GI condition can directly cause or worsen anxiety itself. The gut and brain are constantly sending signals back and forth in a complex gut-brain axis.
The Problematic Cycle of GI Issues and Anxiety
Dr. Marks uses the example of a patient named Paul who has gastroesophageal reflux disease (GERD). Paul gets burning chest pain from stomach acid splashing up into his esophagus, especially when lying down to sleep. This chest pain triggers panic attacks and anxiety over fears he may be having a heart attack or something more serious like cancer.
His anxiety then makes the reflux worse, creating a vicious cycle of GI symptoms causing anxiety, which exacerbates the GI issues further. The physical pain and symptoms fuel catastrophic thoughts and health anxiety. As Dr. Marks states, “Paul has gastroesophageal reflux disease, and this is something that can be worsened by anxiety, but GERD can also cause or worsen anxiety.”
The Gut Microbiome and Mental Health
Beyond just the mechanical effects of reflux or other GI disorders, the microbes living in our guts (the gut microbiome) also play a crucial role in regulating mental health. This microbial population of trillions of bacteria, fungi, viruses etc. is sometimes referred to as a “second brain” based in the gut.
Studies comparing the microbiomes of those with anxiety/depression to healthy controls have found distinct differences in the microbial makeups. The microbiome influences the immune system, metabolism, weight and more – so imbalances may directly impact brain function and mood.
Emerging research even indicates that supplementing with certain probiotic strains like Lactobacillus and Bifidobacterium could potentially help treat anxiety and depression, though more research is still needed.
The Troubling Side Effects of Anxiety Medications
One of the reasons it’s so important to recognize this gut-brain relationship is that the standard medication treatments for anxiety, the SSRI antidepressants like Prozac and Zoloft, commonly cause GI side effects like nausea, diarrhea and constipation.
As Dr. Marks states: “The usual medication treatment for anxiety is serotonin enhancing antidepressants like Prozac or Zoloft. But one of the main side effects of these medications is gastrointestinal distress like nausea, diarrhea, or constipation. So they can make your gastrointestinal illness worse.”
Making Your Gut Health a Priority
So what’s the solution if you have a GI disorder contributing to your anxiety? Dr. Marks suggests an alternative approach of first prioritizing treatment for your underlying GI condition before attempting to treat the anxiety.
“An alternative approach may be to focus on getting the optimal treatment for your gastrointestinal symptoms first, and then using cognitive behavioral strategies to address your anxiety.”
She acknowledges that some patients can take acid-reducing medications for GERD, for example, and still tolerate an SSRI for anxiety. However, many cannot due to the GI side effects.
Treating the Root Cause with Diet
Beyond just managing GI conditions with medications, Dr. Marks heavily emphasizes the importance of diet and gut health:
“If gastrointestinal disorders can cause anxiety and having bad microbes can cause or worsen anxiety, then maybe the way you can address your anxiety when you have a gastrointestinal illness is to get treatment for your GI problem first and then turn a hard focus to your gut health.”
She advises eliminating sugar, processed foods, and eating an anti-inflammatory “clean” diet to promote a healthy microbiome. Simple diet changes alone can make a big difference in reducing inflammation, improving gut flora, and alleviating both the GI issues and anxiety without adding more medications.
The Bottom Line
If you struggle with anxiety and GI problems like GERD, IBS, colitis or others, don’t just write it off as stress. There is a physiological gut-brain connection where the two can reinforce each other. Prioritize treating your gut issues first through dietary changes, medications, or other therapies as needed.
Once you get your gut health optimized, then layering on cognitive-behavioral strategies or other therapies can help address the anxiety more effectively without GI medication side effects derailing your progress. And focus on nurturing your microbiome through a high-fiber, probiotic-rich diet. You may find your anxiety significantly improves once you start from the foundation of a healthy gut.